Weekends Worse For Heart Attacks
Fewer Staff and Sicker Patients May Be a Lethal Combination
April 3, 2003 (Chicago) -- There is no good time for a heart attack, but researchers report that weekends are a particularly bad time for heart attacks.
People who have a heart attack on Saturday or Sunday and undergo invasive procedures such as balloon angioplasty or stenting to treat the heart attack have a 47% increased risk for dying in the hospital.
And that's not all -- even if one survives a weekend heart attack the risk for having a second heart attack while hospitalized is 48% higher than the second heart attack risk for people who have attacks during weekdays.
Mauro Moscucci, MD, director of interventional cardiology at the University of Michigan in Ann Arbor tells WebMD that patients treated at night also face increased risk for complications but says that increase was not statistically significant.
Moscucci discovered the relationship between fatal heart attacks and day of the week and time of day after analyzing medical records from more than 25,000 heart attack patients who underwent heart attack treatment at eight Michigan hospitals between July 1997 and September 2001.
He presented the research at the American College of Cardiology 52nd annual scientific meeting held here this week.
Along with increased heart attack deaths, off-hour treatment was also associated with more strokes, more blood transfusions, and more patients rushed to the operating room for emergency bypass surgery, he says.
Moscucci says there are a number of factors that could explain this higher risk. "Typically there is fewer staff available at night and over weekends so there could be some delay in getting treatment," he says. But he says he doubts that staffing problems explain all of the excess deaths.
"I think there is a chance that these patients have more severe disease or are waiting longer before seeking treatment," he says
David Williams, MD, of Rhode Island Hospital in Providence, R.I., tells WebMD that "patients do tend to delay seeking treatment on weekends. I think people are reluctant to visit an emergency room on their days off and so they may minimize symptoms." He says the reluctance might explain the increased risk of nighttime heart attacks, but he conceded that most hospitals operate at less than full staff after traditional business hours. Williams was not involved in the study.
Source: American College of Cardiology, Abstract 885-6 presented April 2, 2003. Mauro Moscucci, MD, director of interventional cardiology at the University of Michigan in Ann Arbor. David Williams, MD of Rhode Island Hospital in Providence, R.I.